Aims and objectives
There is an increasing role for ablative techniques in the management of the incidentally discovered renal malignancy,
particularly in patients with multiple comorbidities.
Percutaneous ablation has been shown to be a good option for patients with cT1a tumors (≤4.0cm) with recurrence and metastasis-free survival rates comparable to those of partial nephrectomy (1).
The use of ablative techniques for larger tumors,
cT1b (4.1-7.0cm) however,
has not yet been widely adopted.
This is in part due to concern that cryoablation of higher T-stage RCC may be associated...
Methods and materials
A retrospective review of the medical records of 37 patients with RCC lesions measuring 4 – 7 cm who underwent percutaneous cryoablation from 2004-2018 was performed.
technical parameters of the procedure,
and local recurrence rates were recorded.
The RENAL and PADUA scores were calculated and patients were categorized accordingly. Technical success and complications were analyzed.
Technical success was defined by the absence of new contrast enhancement and the absence of tumor enlargement within 3 months of ablation....
The study included 37 patients,
with22 (59.5%) males and 15 (40.5%) females.There was23 (62.2%) Caucasians,
9 (24.3%)African Americans and5 (13.5%) other ethnicities.
Themean agewas 65.5 (SD=11.3) years.
There were16 (43.2%) patients with CKD stage 3,1 (2.7%) patientsCKD stage 4,
and 3 (8.1%) patients CKD stage 5.
The mean BMI was 34.8(SD=8.8).
The median comorbidity index was 7 (range=2-12) (Table 1 ).
The mean tumor diameter was 4.7 cm (±0.63).
score was low in 10 (27%),
moderate in 21 (56.8%) and high in 6...
Percutaneous cryoablation is a viable therapeutic option for stage T1b RCC with an overall low rate of major complications.
nearness to the collecting system,
involvement of renal sinus and displacement/infiltration of the collecting systemwere independent predictors of complications.
Ahmed Kamel Abdel Aal,
Division of Interventional radiology
University of Alabama at Birmingham (UAB)
Department of Radiology619 19th Street South
Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses.
et al .
Percutaneous cryoablation of stage T1b renal cell carcinoma: technique considerations,
and local tumor control.
J Vasc Interv Radiol,